This paper considers the environmental impact on well-being and performance in elite athletes during Olympic competition. The benefits of exercising in natural environments are recognized, but less is known about the effects on performance and health in elite athletes. Although some Olympic events take place in natural environments, the majority occur in the host city, usually a large densely populated area where low exposure to natural environments is compounded by exposure to high levels of air, water, and noise pollution in the ambient environment. By combining methods and expertise from diverse but inter-related disciplines including environmental psychology, exercise physiology, biomechanics, environmental science, and epidemiology, a transdisciplinary approach will facilitate a greater understanding of the effects of the environment on Olympic athletes.
Background
There is overwhelming evidence to support the promotion of physical activity in adults in terms of benefits to well-being, physical and mental health. Physical activity guidelines suggest that adults should accumulate at least 150 min of moderate to vigorous physical activity per week. In Ireland, the majority of adults do not achieve these guidelines, with costs to health and economy. ‘Move for Life’ (MFL) employs behavioural change techniques delivered by an instructor and peer mentor, using a train-the-trainer (cascade) model. This study will conduct a feasibility cluster randomised controlled trial of the MFL intervention for modifying physical activity behaviours in inactive adults aged 45 years and older.
Methods
The trial is set in eight Local Sports Partnership (LSP) hubs that have structured physical activity programmes. The hubs are the units of randomisation (clusters), and individuals are the units of analysis (participants). Eligible participants will contact one of the hubs, with each hub running four physical activity programmes. Each programme requires between 12–15 inactive adults, resulting in 48–60 participants per hub. Allowing for 20% dropout rate, an additional 96 people will be recruited giving a maximum sample of 576. The hub will be randomised: true control, usual programme or MFL intervention. The true control group will be given information about physical activity but will not be included in a programme for the duration of the trial; the intervention will involve the instructor training one (or more) of the participants to be a peer mentor using an educational toolkit; and usual care groups will have physical activity classes delivered as normal. Baseline data will collect physical activity measures and follow-up measurements will be obtained at 3 and 6 months. All participants will be asked to wear a device for measuring activity on the thigh (activPAL) for 7 days before commencing the programme and at 3 and 6 months. The primary objective of the study is to investigate if it is feasible to deliver the intervention and collect data on moderate to vigorous physical activity (MVPA) on all participants, thereby providing valuable information to guide sample size calculation for a future, more definitive trial.
Trial registration number
ISRCTN11235176
Electronic supplementary material
The online version of this article (10.1186/s40814-019-0473-y) contains supplementary material, which is available to authorized users.
Background
The aims of this study were to explore the impact of COVID-19 on health-care services and quality of life (QoL) in women diagnosed with breast cancer (BC) in Ireland and whether the impact varied by social determinants of health (SDH).
Methods
Women diagnosed with BC completed a questionnaire measuring the impact of COVID-19, disruption to BC services, QoL, SDH, and clinical covariates during COVID-19 restrictions. The association between COVID-19 impact and disruption to BC services and QoL was assessed using multivariable regression with adjustment for SDH and clinical covariates. An interaction between COVID-19 impact and health insurance status was assessed within the regression models.
Results
A total of 30.5% (n = 109) of women reported high COVID-19 impact, and these women experienced more disruption in BC services (odds ratio = 4.95, 95% confidence interval = 2.28 to 10.7, P < .001) and lower QoL (β = −12.01, SE = 3.37, P < .001) compared with women who reported low COVID-19 impact. Health insurance status moderated the effect of COVID-19 on disruption to BC services and QoL. Women who reported high COVID-19 impact experienced more disruption to BC services and lower QoL compared with women with low COVID-19 impact; however, the magnitude of these unfavorable effects differed by insurance status (Pinteraction < .05).
Conclusions
There was a large disruption to BC services and decrease in QoL for women with BC in Ireland during the pandemic. However, the impact was not the same for all women. It is important that women with BC are reintegrated into proper care and QoL is addressed through multidisciplinary support services.
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